Which fertility test is best?
Many women who come to my clinic are often curious
about how fertile they are.
If you are trying to conceive there are a few fertility tests which might come in useful for you to know about. All of them need to be authorised by your General Practitioner or Gynaecologist/Obstetrician.
A naturopath who specialises in fertility and women’s health can help suggest which tests are most appropriate for you, and follow up with the best possible treatment to enhance your chances of falling pregnant.
A few things you need to know:
It is very important that these tests will NOT diagnose you as being infertile, but can be very helpful at ruling out underlying causes to why you may not have conceived yet. For example, conditions like Poly Cystic Ovarian Syndrome (PCOS) are commonly undiagnosed and in some cases the primary reason for infertility in women under 40 years.
– These tests can only really be of help to you if you are not taking the oral contraceptive pill/ have an IUD or taking other hormone therapy.
– Some of the results will vary depending on what time of the month you have the test, as your oestrogen, progesterone, FSH, and LH all change at various points during the cycle.
– Vitamins, minerals, and herbal medicines may also affect the tests, so it is best to avoid supplementing for 2 days prior to the test.
Blood tests for female fertility
Full blood count– to make sure there aren’t any serious health concerns.
Fasting blood sugar and insulin– to ensure your blood sugar levels are under control. These can have a drastic effect on your fertility, and if they come up abnormal you may need further diagnostic testing done.
Cholesterol and trigylcerides– if these are too high or too low they may impact on your hormone production.
Thyroid function tests– TSH, T3, T4, free T4, and thyroid antibodies– these tests may show an underlying thyroid condition. Normal thyroid function is very important when it comes to fertility. Nutritional medicine and diet can help manage this in some instances, in other cases medication may be required.
Oestrogen, progesterone, FSH, LH– these are your sexual hormones needed to regulate your cycle and help with falling pregnant. In many cases they may be out of the normal ranges due to an underlying medical condition eg. PCOS. To help regulate them (once you are no longer using hormonal contraceptive methods like the pill) your naturopath may be able to suggest herbal medicine and nutritional therapy to get them to their optimal levels for conception.
SHBG, FAI, testosterone– these hormones may show androgen excess in women, which can affect your fertility. Again diet and herbal medicines may improve these markers over a 3-6 month period.
AMH– this test is a great indicator of your egg reserve. If you are under 38 years and trying to conceive this test is highly indicated. It counts the levels of your remaining ‘egg supply’. In a way it can indicate to you and your partner if you need to make falling pregnant a priority. As women age, there egg count drops, so this test (not covered by medicare) can be confronting for some.
MTHFR– this is a genetic test that affects approximately 1 in 4 people seriously and nearly 1 in 2 people mildly. The MTHFR gene has a simple, but highly critical, function surrounding how your body utilizes folic acid and other forms of folate. Depending on the outcome it can reduce your chances of falling pregnant. Various nutritional protocols can address this genetic condition.
Magnesium & Calcium– deficiencies in these minerals may affect various aspects of your health and wellbeing, and when trying to conceive it is important that all of your nutrient levels are at their optimal levels.
Iron studies with Vitamin B12– Iron and B12 are required for energy production, immune support, and a healthy menstrual cycle. If your body is deficient in these nutrients high quality supplements are indicated (ask your naturopath which one is best for you, as there are many different types of iron out there).
Folate- it is commonly known in the medical world that supplementing with folic acid can help reduce the risk of neural tube defects in the early stages of pregnancy. One the implicating factors when your MTHFR gene is expressed poorly is your methylation of folic acid may not be working correctly. So while supplementing with folic acid is indicated, we really need to be checking the genetic test of the MTHFR gene in combination before supplementing.
Vitamin D– this fat soluble vitamin has shown to be highly important during pregnancy, so making sure that your levels are adequate prior to conception is recommended. Ensuring that you are getting natural exposure to vitamin D via 10-20 minutes of uninterrupted sun exposure, and possibly taking a synthetic supplement.
Physical examination and Imaging for female fertility
Vaginal examination- your GP or Gynaecologist can perform a simple examination in their clinic to check the your cervix is clear, and that there are no physical contributions to infertility.
Pelvic ultrasound– a referral for a pelvic ultrasound is invaluable if you haven’t had one before. The Sonographer can have a look at the lining of your uterus and the shape/angle. These attributes do affect fertility and can be helpful to know prior to trying to conceive. They can also look at the ovaries and check for cysts (a very telling sign of PCOS).
HYCOSY- this test needs to be done under anaesthetic. A more serious test used to check if the fallopian tubes are blocked. Some STD’s can contribute to blockages of the fallopian tubes and can seriously impact fertility. The procedure is not done unless there is reason enough to check.
This comprehensive list is a suggested collection of tests that might help your practitioner know where you stand in the fertility stakes. If you have been trying consistently for 6 months without falling pregnant, or falling pregnant but sadly experiencing a miscarriage then ask your doctor to run these tests, and speak to your naturopath about what they can do to help.